Preprint / Version 1

Role of herbal medicines in the management of patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Authors

  • Ansul Kumar aRajendra Institute of Medical Sciences (RIMS), CTVS Department, Bariatu, Ranchi, 834009, India
  • Arpita Rai bOral Medicine and Radiology, Dental Institute. Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi, 834009, India
  • Mohd Khan cCritical Care Medicine, New Trauma Centre & Central Emergency, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi, 834009, India
  • Amit Kumar dRajendra Institute of Medical Sciences (RIMS) Dept of Lab Medicine, Bariatu, Ranchi, 834009, India
  • Zeya Haque aRajendra Institute of Medical Sciences (RIMS), CTVS Department, Bariatu, Ranchi, 834009, India
  • Mohammad Fazil eHakim Ajmal Khan Institute of Literary and Historical Research in Unani Medicine, CCRUM, Jamia Millia Islamia Campus, New Delhi, 110025, India
  • Gulam Rabbani fCHC-Karra, Khunti, Jharkhand, 835209, India

Keywords:

COVID-19, Herbal medicine, Systematic review, Meta-analysis

Abstract

Background and aim The management of the worldwide spreading COVID-19 consists of amelioration of its symptoms but no cure is yet available. Herbal medicines supplemented with the Western medicine have been applied for COVID-19 treatment in India, China, Iran, and other countries. This systematic review and meta-analysis of RCTs evaluates the effect and safety of herbal intervention in the management of COVID-19. Experimental procedure RCTs from databases like PubMed, Cochrane Library, ScienceDirect, Google Scholar, Science Direct, CTRI, AYUSH Research Portal, India, were reviewed and the data were extracted for study sample demographics, intervention details, clinical effect, inflammatory markers and safety monitoring. Outcomes were expressed as Risk-ratio (RR) with 95% CI for dichotomous data, and Mean-Difference (MD) with 95% CI for continuous data. Result and conclusion From the 32 eligible studies, a total of 3177 COVID-19 patients were included in the review. Herbal intervention as an adjuvant to Western medicine causes significantly higher improvement compared to Western medicine alone [Fever (RR = 1.09 CI 1.03, 1.15), Cough (Risk-Ratio = 1.22 CI 1.08, 1.37), Fatigue (Risk-Ratio = 1.27 CI 1.11, 1.44), Chest CT Improvement (Risk-Ratio = 1.15 CI 1.08, 1.23)]. The laboratory parameters were also better in the herbal medicine group compared to standard care group only WBC (MD = 0.36 CI 0.16, 0.55), Lymphocyte percentage (MD = 5.48 CI 3.05, 7.92), Absolute lymphocyte count (MD = 0.23 CI 0.07, 0.39), CRP (MD = −5.66 CI -7.96, −3.37). However, duration of hospital stays (MD = −1.82 CI -3.84, 0.21); IL-6 (MD = −3.67 CI -8.76, 1.43), ESR Level (MD = −10.38 CI -25.96, 5.21) were statistically insignificant. No significant adverse events for herbal medications were noted in the included RCTs, during the time of the studies. (n = 665, RR 0.93; 95% CI 0.76, 1.14). Keywords: COVID-19, Herbal medicine, Systematic review, Meta-analysis

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